Legal battle rages over whether ankles exist

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For every foot, there's an ankle. Or not.

In Texas, that all depends on a legal battle between medical doctors and podiatrists, who both claim the ankle as their turf. The debate has raged to the point that the two sides disagree in court on whether the ankle actually exists.

A state appeals court recently sided with medical doctors when it determined that the state board that licenses podiatrists exceeded its authority in defining the ankle as part of the foot.

"You don't have an ankle," said Mark Hanna, a lawyer for the Texas Podiatric Medical Association. "The foot actually includes the ankle. If you took the foot off the leg, there is nothing lying there that's the ankle."

Not so, said Dr. David Teuscher, an orthopedic surgeon in Beaumont who said treating the ankle is complicated enough to require medical school training.

"If they say the ankle doesn't exist, why do they want to operate on it?" asked Teuscher, immediate past president of the Texas Orthopaedic Association. "Everyone knows what an ankle is."

The Texas State Board of Podiatric Medical Examiners bypassed the Legislature to create its ankle-is-part-of-the-foot definition in 2001. Podiatrists say they've been treating ankles for decades and accuse medical doctors of trying to limit competition. The Texas Medical Association argues podiatrists should stick to corns, calluses and diabetic foot care.

The physicians group interprets last Friday's ruling as saying the ankle and foot are separate. The podiatrists group says the ruling doesn't go that far and plans to appeal. About 900 podiatrists await the outcome.

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USCIS Adjusting Premium Processing Fee

U.S. Citizenship and Immigration Services (USCIS) announced today it is adjusting the premium processing fee for Form I-129, Petition for a Nonimmigrant Worker and Form I-140, Immigrant Petition for Alien Workers beginning on Oct. 1, 2018 to more effectively adjudicate petitions and maintain effective service to petitioners.

The premium processing fee will increase to $1,410, a 14.92 percent increase (after rounding) from the current fee of $1,225. This increase, which is done in accordance with the Immigration and Nationality Act, represents the percentage change in inflation since the fee was last increased in 2010 based on the Consumer Price Index for all Urban Consumers.

“Because premium processing fees have not been adjusted since 2010, our ability to improve the adjudications and service processes for all petitioners has been hindered as we’ve experienced significantly higher demand for immigration benefits. Ultimately, adjusting the premium processing fee will allow us to continue making necessary investments in staff and technology to administer various immigration benefit requests more effectively and efficiently,” said Chief Financial Officer Joseph Moore. “USCIS will continue adjudicating all petitions on a case-by-case basis to determine if they meet all standards required under applicable law, policies, and regulations.”

Premium processing is an optional service that is currently authorized for certain petitioners filing Forms I-129 or I-140. The system allows petitioners to request 15-day processing of certain employment-based immigration benefit requests if they pay an extra fee. The premium processing fee is paid in addition to the base filing fee and any other applicable fees, which cannot be waived.